45D0975742 CLIA NUMBER - FISH POND SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 45D0975742
  • Facility Name: FISH POND SURGERY CENTER LLC
  • Facility Address: 601 W STATE HWY 6 # 109
    WACO, TX
    ZIP 76710
  • Facility Phone: 254 751-9837
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JEANETTE MARLETT
  • NPI Number: 1477569069
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0975742
LAB Type Ambulatory Surgery Center
Facility Name FISH POND SURGERY CENTER LLC
Street 601 W STATE HWY 6 # 109
City WACO
State TX
ZIP 76710
Phone 254 751-9837
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Ambulatory Surgery Center
Lab Director JEANETTE MARLETT

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This page was last updated on: 9/29/2025